More choice for mother to be

Posted 03/12/2014

Every woman should have the freedom to choose where she wants to give birth and be supported in her choice as the National Institute for Health and Care Excellence (NICE) say a home birth may be just as safe for low-risk pregnancies.

Rosaline Wong, clinical negligence lawyer at Ashtons Legal who specialises in birth injury claims said: “Statistics published by the Office for National Statistics show that there has been a decline in home births since 2008. Only 2.3% of all births in England and Wales were delivered at home.

Published evidence shows that 45% of women are at extremely low risk of complications and may be better off giving birth at home or midwife-led units. Over the years, the demand for home births remains high but not all of the women who wish to give birth at home are supported. Women with medical conditions and complications in pregnancy are not eligible for a home birth but it does not mean that those who fulfil the low risk criteria are offered a home birth. On many occasions planned home births are cancelled at the last minute because of midwife shortage.

It will not surprise me if there will be a surge for home births since NICE now says birth is  safe wherever it happens. However can this new guideline be fully implemented given we have a chronic shortage of midwives? I do not wish to dwell for too long on how many maternity units are operating at dangerous levels already or how many units are going to be axed but unless recruitment crises are tackled, home birth which requires one to one care may just be a dream to a lot of women.

Even though there is no difference in the number of medical problems with the baby between hospital and home birth settings, childbirth remains an unpredictable event whereby maternal and baby conditions can change in a split second. When things go wrong, they go terribly wrong with lasting consequences. Mother and baby will need an urgent transfer to hospital in the event of an emergency.

Therefore, in order to implement the NICE guidelines, not only chronic staff shortages have to be tackled quickly, we will need more investment in midwifery and emergency ambulance services as well. Undoubtedly more midwife-led units will be needed but these must be next to or in close proximity of a fully equipped obstetric unit to ensure the safest possible care and outcome for women and their babies”.